My topic today is about how to prioritize your bucket list when you have multiple financial goals and how should you go about it. The reason I'm talking about this is because it's super important for wellness and work-life balance. It's complicated. We don't learn about this in medical school, residency, or fellowship. I gained my knowledge from the CPA, the CFP, and the webinar, the books, the newsletter, investments, and mistakes that I made throughout the years. After founding my own investment company in 2019, I did a lot of equity, so stocks and options trading, and we are currently debt-free and financially independent. So objectives is we're going to talk about what is financial independence, why this is important, there are five tips to do it and not suffer, and 12 steps to prioritize your goals. So here are the reasons to become financially independent. What would you do with nine extra hours every day? You could live anywhere and travel anytime you want. Your job actually becomes more enjoyable when you don't have to do it for money because you got the walking money. If you're not happy, you could walk. And you work when you want. You can go part-time. You can do less calls, less weekends. You can actually spend more money on yourself and your family and anything that you feel important and not feel guilty. And also, you don't need to have life with disability anymore because you're self-insured. So what does this mean? It means you can quit work today while keeping a lifestyle that's reasonable to you. So that's different for everyone. What's reasonable to me is not the same as what's reasonable to you. So you can still continue to work because you love it, you enjoy your colleagues, you enjoy your patients, and you can lift off the savings and also the passive income that my colleague is going to talk about in the remainder of this course. And the rule of thumb, this is the general rules. It is not 100% bulletproof. In general, you need to save about 25 times of your yearly spending. So to break this down, if you spend $10,000 per month, that's $120,000 per year. You need to save about $3 million and call yourself financially independent. And if you spend double of that, it's $20,000 a month and you need about $6 million. So when I gave this talk at Rank and Rate last year, one audience came up to me and said, this is wrong. There's no way I could save 25 times of my spending. I was like, what do you mean? He said, I spend a million dollars a year. I'm going to have to work until I'm dead to save $25 million. So just keep that in mind. This is a general rule of thumb. So the five tips. Number one, these are some of the services and products I use to help me front load and automate your savings. White Coat Investor is very well known. It really gives you very simple to read, easy to understand, five-minute blogs for any topic of your interest. It's a good introduction. There's also an online-based banking. It's called Ally Bank. That's where I park my short-term money. If I need to, I don't know, put a down payment down and I want to park it for six months, but I don't want it to be just sitting there with 0.01% interest, I will just go buy a six-month CD with Ally and it pays 4.2% interest, way better than the regular checking. Mint is another website. My sister really likes using this. It keeps everything under one umbrella. It's just an app. Merrill and Bank America is what I use for investing because they are actually one company. Bank America bought Merrill in 2009, so it can actually very easily transfer your bank account money into Merrill and invest it. So it makes it very seamless. Automatic deposit, direct deposits, retirement contribution, investment can all be automated. The goal is to get in the habit of saving and you can prepare for that later lifestyle inflation that we're going to enjoy. So I also found the Robot Advisors helpful. This is not for everyone. So this basically means this is a financial advisor service. It's online. It is a robotic. It is a machine. It's a formula that you will have to choose based on your risk tolerance level and also how much time horizon do you have for the investment. And these are the top three recommended brokers based on nerdwallet.com. They have much lower AUM fee, asset under management fees. Usually if you go to a human advisor, it's usually about 1% to 1.25%, which adds up when you have quite a bit if you have a lot of money to invest. They do offer automatic portfolio rebalancing. That means when the stock market is doing well, your portfolio is heavily weighted towards stocks. So at the end of the year, you don't want those extra risk, right? You want to maintain the same, you know, 70-30, 60-40 ratio. So this will actually do that automatic rebalancing for you. You have access to different asset classes and tools for financial planners. So first step, we got to create a budget. What is the biggest mistake people make when creating the budget? Anybody? They forgot about the taxes, right? You got to pay your taxes first, and then we have a budget for the rest of the money. So for example, let's start with a $500k salary, for example. Assume it's W-2. You pay your taxes. If you're in a high-tax state like New York, where I am, you have $300k left after tax. The goal is to follow this 50-30-20 rules, right? 50% go to your needs, your grocery, your gas, your heating, cooling. 30% go to your wants, the Gucci bag I've been eyeing for for a while. The 20% goes to your saving. However, I challenge you to see if you can actually save 50%. So out of the $300k take-home, you have save $150k, spend $90k on your needs, and $60k on your wants. This will really help you get started early and let the money roll, and later you can reverse the ratio as you see fit. So we make enough money. We're fortunate in a sub-specialty-wise that we could really make a lot of money to do anything you want, but not everything. You got to prioritize what matters to you. So for me, it was my kids, education, and we love cruising. So this is what we did for Thanksgiving. Tip three is watch out for those fixed expenses. These fixed expenses have the biggest impact on when you can go financially independent. So get rid of those student loans quickly. Don't buy fancy cars until you can afford it. Don't carry any balances on your credit card. The first house should ideally be what you can afford with a 20% down payment to maximize your mortgage rates. And if you can't afford a 15-year mortgage, take the 15 years and then try to get rid of it early, especially the rates here are so high. For example, this is a calculator that shows you how much money you could save with a 15-year mortgage instead of a 30-year. Okay. Tip number four, when you start to spend more money, be careful because you're weighing the joy you get for that vacation home in Florida that you go three times a year versus the extra 500k mortgage that you just took on and now you have to take extra calls and work longer hours to pay for it. So is it one time? Was it a regularly occurring expense? Would it increase your fixed expenses? For example, the insurance and the maintenance costs. That comes with the second home, the car, the boat, the RV, your plane, for example. Tip five. So Dr. Jeff Klein will touch about this in a little bit and it's about asset protection. What is the easiest way to lose half of your money? And you want to be careful with your level of risk tolerance. If you're someone who bites their nail while watching CNN, CNBC news and the market is going up and down before and after the election, you probably should not invest aggressively. Okay. You want to make sure you have insurance protection. So here are the five tips to do it all. And now we're going to jump in and to see how we're going to organize this in the 12-step program. So this is a list of common financial goals that people have. You have an emergency fund, you need a down payment for the house, you got credit card debt, some student loan, but you want to go to a nice fancy European vacation, you want a Miata, you want to max out your 401k and also have a new vacation home. Wait, there's kids college too and retirement. So number one thing is you make a list. These are your goals, limited to 10. When it becomes 25, it's very hard to manage. So make a list of your top 10 goals and put down how much money you will need for each one. And then you categorize these by time. Are these short-term, meaning less than two years, mid-term, which is two to 10 years, or long-term, like retirement or college saving account, which is more than 10 years out. You invest in different asset classes, depending on how much time you have. And then at end of each year, you go back and review them to make sure you're still on track. So stage one is the planning. You got to start calculating your net worth. So I do this once a year. I have my spreadsheet set up. We go through how much debt we have, how much assets we have, and then look at are we saving that 50% that we thought we are. You got to live like a resident for that first two to five years. There's no easy way out of this. And get rid of the student loan payment. Don't buy anything until they're broken. Our first air fryer lasts for 10 years, and we used it daily until it is really dead, dead. Insurance, important. Disability and term, for sure. And then make sure you have that one-month emergency fund. 5k is a good place to aim for. If you happen to spend it, stop, save it, and then go on. So this is actually an example of my current job. I work for the State University of New York. This is all the variety of flavors of retirement plans we have. So got to make sure you contribute enough so you get your employer match. That is free money on the table. Okay. You got to know your account. You got to know how much you can put in there as a pre-tax, as a post-tax. If you have consulting income on the side, a 1099 check, make sure you have a SEP IRA or maybe a solo 401k if you want to contribute more and do a mega backdoor Roth conversion. There's also defined benefit plans if you're in private practice. Make sure you max out your pre-tax retirement plans. It's up to $27,000 in 2024. It's a great place to invest your money. Now you're ready to increase your emergency fund. So you can pile up about 10 or 20 in account. Now your net worth is going up quickly. Save up that down payment. You get the best rates if you have 20% down. And you can start thinking about that doctor house, Dr. Bo, the business class tickets, vacations, and you're still continuing to tuck away about 20 to 50% of your income for retirement. So this is the fun part. So you're all set for your own retirement. You got to remember to pay for yourself first. Some people are prioritizing the 529 before their own college debt. Don't do that. You got to make sure you are independent before you can help your kids. So this is why this is step number 10 out of 12. And you decide how much you want to pay for their college. My goal was to supply them with college tuition followed by four-year additional med school, dental school, law school, if I'm lucky, tuition. So I'm putting a lot more than usual into their accounts. And I started at birth. Superfunding is an interesting concept. IRS allows you to make a one-time $90,000 one-time dump to front load a 529. And it's exempt from the gift tax if you don't contribute for the next five years to their 529. So it will be growing with time. Pay off your mortgage. And now you're ready to do some estate planning, your whole life, your trust. And you can retire or not. So the take-home point is that make a list of everything and how much you need for each one. You organize them by time. And here is a 12-step program to do it all. And that's all I got. Thank you. And today I'm going to be talking about constructing a portfolio for retirement. And so if you remember just a few things from this presentation, keep in mind that simplicity is key. It's important to set specific goals. And once you've developed your asset allocation, make sure you implement it and have a plan for adjustments as you approach retirement. And so the first point when constructing your portfolio is simplicity is key. Now, there's a common belief that having more choices enhances our experiences. We see this in everyday life. At the supermarket, there's a whole aisle dedicated to different types of soda and chips, the ice cream parlor that offers 31 flavors to choose from. The investment world is very similar with countless options available, such as stocks, bonds, mutual funds, real estate, small companies, large companies, options, and many more. So two psychologists from Columbia and Stanford examined this paradox of choice through three separate but related studies, all revealing the same outcome. In one of their studies, they explored whether consumers generally preferred having more choices. They set up two tasting tables, one with 24 different jams and another with just six. And their questions were pretty straightforward. Which table attracted more customers and which led to more sales? As expected, the table of 24 jams and jellies attracted 60% of passing customers compared to just 40% for the table that only had six jams. The larger selection was initially more appealing because of the variety it offered. However, the table with fewer options resulted in 10 times more sales than the one with the extensive selection. So while consumers were initially drawn to having more choices, they were much more likely to make a purchase when presented with fewer options. This study and others really illustrates this paradox of choice, which suggests that when we're faced with too many options, we can feel overwhelmed and anxious, leading to this analysis paralysis, where basically it's difficult to make any sort of decision. And even if we make a decision in this setting, it often results in regret, dissatisfaction, because we worry that there is a better choice out there that we might have missed. And so having too many options, including investment options, often paralyzes us from making any sort of decision. And so when you're thinking about asset allocation, I think simplicity is really key. So point one, when you're designing your portfolio, is the simplicity. The second point is to set specific goals and understand that you may need to adjust your plan over time to achieve them. For example, a specific goal would be, I want to retire at age 55 with an annual income of $120,000, rather than a vague goal like, I want to retire someday. When setting a specific goal for retirement income, it's helpful to estimate your annual expenses in retirement, including costs like taxes, health care, and any sort of travel you want to do. Once you have this figure, you're going to subtract any sort of guaranteed income, such as like a pension that you may have, Social Security if you're in the United States. And then finally, you're going to apply a safe withdrawal rate. So Sydney touched us on a little bit about the 4% rule, but the safe withdrawal rate is how much you can actually withdraw from your accounts each year to ensure that your savings are going to last you throughout your retirement. And so when setting a savings goal, it's helpful to consider four key variables. Number one, your savings rate. Two is the length of time you're going to be saving, the return on your investment, and your withdrawal rate during retirement. And let's take a look at each of these four variables. The first factor is your savings rate, which is arguably probably the most significant determinant of how long it's going to take you to reach your retirement goal. Given our relatively late start, due to the length of our training, you really need a minimum savings rate of about 20% of your gross income over your career in order to retire at a reasonable age, you know, 60 to 65. If you want to aim for the possibility of early retirement, you're going to need to have a much higher percentage than that 20%. The second variable is time. So how long you plan to work. A longer time horizon is going to allow for a lower savings rate. Conversely, if you're just starting saving at the age of 55, you're going to need to adjust several factors. Maybe you're going to increase your savings rate, decide that you're going to work beyond the standard retirement age, or boost your income through additional side ventures. The third variable is what do you actually get from your portfolio? So what's the return on your portfolio? How much does it generate annually? And it's best when you think about your return to use real returns, which are going to be adjusted for inflation. So meaning $10,000 today is going to have the same purchasing power 30 years from now, since you adjusted to include inflationary calculation. A general guideline is to assume a real return of around four to 6% on your portfolio. Historically, broadly diversified stock investments have provided a 6% real return since 1976, whereas bonds have delivered a 3.35% real return since 1986. The final variable is going to be your withdrawal rate. So this helps determine how much you can draw from your assets or portfolio once you retire. The longer your retirement period, the lower your safe withdrawal rate should be. Conversely, if you retire at the age of 75, because you really love your job, you can typically sustain a much higher safe withdrawal rate. And you're able to withdraw more each year. If you plan to adjust your withdraws upward for inflation, so each year kind of increasing how much you withdraw, you're going to need a lower safe withdrawal rate. I'll say that the 4% rule is considered very conservative. So Sidney kind of mentioned this. And this really accounts for worst case scenarios. So in most cases, if you use a 4% withdrawal rate, you're actually going to have more assets at the end of your retirement than you started with. And so there's several calculators that I find helpful to help assist with this calculation. So if you search for calculator and net worthify, this is going to bring up a tool that lets you input variables such as your current annual savings, your portfolio value, your expected return, usually again in the 4% to 6% range, and what's your planned withdrawal rate. After entering these details, the calculator is going to provide an estimate of when you can expect to retire, assuming the variables align. This is another useful tool from investor.gov. This tool helps estimate how your portfolio is going to grow over time. You can input your initial portfolio value, what your monthly contributions are going to be, the duration of your contributions, and your expected rate of return. And again, by adjusting for the inflation by using a real or after inflation return, the calculator is going to show you the projected value of your portfolio in today's dollars over the selected time frame. And so point number two is set specific goals. So finally, let's discuss portfolio asset allocation. Generally, it's helpful to consider having up to four different asset classes. So equities or stocks, fixed income in the form of bonds and cash, real estate, and any sort of alternative assets, such as maybe an individual business that you own, collectibles, or even cryptocurrency. Remembering again that simplicity is key, it's beneficial to keep your allocation straightforward to easily manage throughout your lifetime. And while some investors may choose to only focus on one or two of these asset classes, that's perfectly fine because having all four is not necessary for success. An ideal asset class should have a long-term positive expected return that outpaces inflation. It should also have a low correlation with any other asset classes in your portfolio and include a sufficient number of securities or companies to reduce individual risk. For example, the S&P 500 index, which comprises 500 distinct large companies, is a strong investment choice due to its broad diversification. In contrast, having a fund that only has 10 different companies or 10 different types of stock would be less desirable due to its limited diversification. A key consideration when building your portfolio is determining the ratio of stocks to bonds. This is going to help influence your risk tolerance, so your risk level, as well as your expected return. Generally, the higher your bond allocation is going to reduce risk as well as reduce your return, while a higher stock allocation is going to increase both. Jack Bogle, the founder of Vanguard, suggested that your stock's percentage should be 100 minus your age. Ben Graham, a renowned investor, advised that your stock allocation should never exceed 75%. Warren Buffett, widely regarded as probably the greatest investor of our time, has often credited much of his investing knowledge to Ben Graham. And so when determining your stock to bond ratio, consider your risk tolerance. And really, if you haven't experienced a bear market or a down market yet, it's very wise to start conservatively with a higher bond allocation. This helps avoid the risk of panicking and selling assets at the worst possible time during a market downturn, which can really happen if your portfolio is too risky and keeps you up at night. You can expect to see your stock investments lose up to half their value at least two to three times during your lifetime. And so really, until you've gauged how you handle these market downturns, it's wise just to have a more conservative portfolio until you really know your risk tolerance. Another question to consider is how much international stock exposure to include in your portfolio. This isn't really agreed upon. You're going to get different ideas depending on what source you look at. So the White Coat Investor recommends allocating between 20% to 55% of your total stock investments to international stocks. Some authors and investors prefer not to invest internationally, arguing if you live in the U.S. that many large U.S. companies are actually global. They have a global presence. The key here, though, is to choose a reasonable percentage that, again, aligns with your strategy and maintain that allocation consistently, regardless of what the market is doing. Finally, you want to consider whether or not to tilt your portfolio. And so in a market-weighted portfolio, you invest in stocks and bonds according to the size of those companies. All that we're talking about with tilting is this involves adjusting your portfolio towards higher risk, higher return assets, such as small cap companies, so the smaller companies we probably haven't heard of, value stocks, merging markets, or even junk bonds. And again, there isn't really a definitive answer here, but it's best to just pick a strategy and then stick to it. And so here are a few simple portfolio options to consider. The first one is called the three-fund portfolio. And so if you're a U.S. investor, this would include a total U.S. stock market investor. You could substitute your own company if you're from a different, or your own country if you're from a different country other than the U.S. It also contains international stocks in the form of a total international stock market index. And then finally, you have bonds in the form of a total bond market index. The four-fund portfolio just expands on that three-fund portfolio by adding real estate to the mix. And then finally, probably the simplest thing is just picking a target date fund for retirement. So figuring out when you plan to retire and picking that in your retirement accounts. And that'll actually adjust your domestic and international exposure with bond exposure as you get closer to retirement. This is my family's portfolio, which includes about 70% equities and stocks with an 80-20 split between domestic stocks and international stocks. We do have a slight tilt towards small and value companies. 15% are in fixed assets, including bond and cash. And then 15% are invested in other asset classes, mainly composed of real estate. So once you've settled on a reasonable portfolio, modify it only occasionally and establish clear rules for adjustments as you approach retirement. You need to stick to your allocation consistently, as frequent changes jumping in and out of the market is going to lead to underperformance or chasing market trends. And it's generally beneficial to use a passive or an index investing approach, and then consider tax-efficient asset placement if you have a brokerage account on the side. Finally, if you have a significant other or partner that you're planning on retiring with, treat all of your accounts as one large portfolio. So you don't need each account to match your overall investment allocation. Some accounts might hold only bonds, whereas others may contain only stocks. But by viewing it all your combined accounts as one large portfolio, you can ensure that your overall investment allocation aligns with your strategy. The general rule is to increase your fixed income or your bond allocation as you age and approach retirement. And this is really based off of four different points. One is wealth protection. You'll likely have a lot more wealth as you approach retirement that you need to safeguard. Two is time to recover. There's less time to recover from significant losses. Three is the income needs. You're gonna have a greater need for stable income. And then four, market sensitivity. You may experience increased anxiety about market volatility or swings. So in summary, remember that simplicity is key. You need to set specific goals, and then finally develop your asset allocation, implement it, and have any plan for adjustments kind of written into your plan as you approach retirement. These are three great resources that I used to kind of put together this presentation. It has a lot more information that I wasn't able to cover. Thank you. So I get to talk kind of about the fun stuff and the stuff that's more optional in portfolios. So I'm gonna talk stuff that's beyond the simple stocks and bonds that Chris advocates for and that I use mostly in my portfolio. So again, the objective in this is really to look beyond stocks and bonds and then the big ETFs, and then trying to figure out what other options are out there and how might they fit into some portfolio construction. So really how I evaluate this is looking at risk versus reward. So kind of an overall how do you evaluate different investments you're looking at. So the specific ones I want to talk about in this talk are leveraged and inverse ETFs. So these are all from mistakes that I've made before. I've traded in options, commodities, and currencies as well. So I'm hoping to share some of my experiences with you so that you're more informed if you decide to go into these things. So again, as a guiding principle, generally in investing, if you take more risk, you're rewarded more, and then there's some more cost associated with that too. So again, here's a risk-reward spectrum of some investments that are available to us. There's again risk-reward spectrum of some things that are available. So government bonds, super safe, right? It's backed by the US government. They're issuing debt to us and they'll pay it back as long as they get tax revenue to support that. But again, the rewards are relatively low. You'll notice interest rates for government bonds are less than interest rates or investment returns you can get with real estate investment trusts. On the other hand, if you go to small cap or penny stocks, futures, options, and forwards, or commodities, you're taking on a lot more risk and often you're compensated because your returns are higher as well. So let's first look at some of the, again, more riskier investments. So these are leveraged and inverse ETFs and funds. So this is a way in the market to profit when the market's actually going up or going down based on what you think it's going to happen in the future. In a normal ETF, you invest in the bucket of stocks. If the S&P 500 goes up 20%, you gain 20%. In these leveraged funds, you gain more than that. So in a three times fund, you would gain 20 or 60%. In an inverse fund, if the market goes down, you actually get money. So again, this is a way to play the market if you have short-term bets that you want to make. So again, one thing when I went into this that I didn't actually know is you can actually be right about the direction of where the market is going. So in my case, I had invested in a China ETF, which I thought was going down because of some of the policies towards the US, which weren't very favorable to Chinese technology companies. And I was absolutely right. The Chinese market went down about 10% over the course of six months. But what I didn't know was all of this was based on derivatives, and they kind of rebalance every day. And so since there was a lot of volatility, it didn't go straight down. It went up, down, up, down, up, down. And here you can see an example, right? Your index fund actually went down 5%. Your inverse ETF, which you would think would go up 5%, actually didn't go down 5%. It went down 5%. And again, if you look at it, it's because they rebalance things every day. And so this is actually a really good instrument if you're betting on a day-by-day volatility basis. So if you're looking at an earnings report for Microsoft, let's say, and you think that it's going to go down, it's a great one-day bet because in that one-day bet, the inverse ETF will closely match what happens in the normal ETF. But over a long time, that's when you really start to lose it because of, number one, the expense ratio, and then, number two, this volatility play. So again, I think for leveraged and inverse ETFs, when do they make sense? If you have a huge position in Tesla and a Tesla earnings call is coming up and you're not quite sure about it, yeah, you could put a very short-term hedge in just so that if that drops, your hedge makes that up. You can also limit losses from existing positions. But again, this is our day job, right? We're radiologists who use multiple screens often to read lots of films. I think this is when it makes sense. If you're a day trader who wants to turn your multiple radiology screens into multiple financial streams, I think it makes a lot of sense for those people that use these inverse ETFs and these high-leverage instruments to move forward. Again, options. This is, again, a more complex strategy. So this is the option to buy or sell a security at a certain price at a certain time. And so with options, there's two types of options. This is super basic. There's call options and there's put options. And if you'll note, the investment banks generally have different levels of options trading defined. So often, if you want to trade options, you just can't trade options right away. You'll have to prove a certain net worth. You'll have to prove a certain length of time you've been investing. And there's a reason for that. These instruments are more complex. And so as you go up those levels, the level of complexity gets higher. The money you can make gets a lot more, but the risk you're taking on gets way, way higher, too. So just be aware that options are out there. You can use them. And again, let me show you what the benefits and what I think the risks are. So again, on low level strategies, covered calls, buying puts, losses tend to be limited. And then you get larger gains due to leverage. And so again, a lot of us are going to cite the white coat investor. He always says leverage cuts both ways. So which means if you use leverage, you can lose lots of money and you can gain lots of money. So don't forget about the two directions that leverage can go. So again, here, if you're buying a stock and it goes up, you gain a little bit because it's gone up. But again, if you bought an option to buy the stock, that you can gain a lot more. But again, options can lose value over time. And they're designed to lose value over time because again, they expire at a certain time. And if they expire and the conditions aren't met, they're basically go to zero. So again, if you look at options here, buying a stock is that dotted line there. And so if you have that dotted line there and you're buying the stock, you can gain and lose a little bit. But again, with options, you can have a huge loss with options, right? Because your option expires worthless. It goes down to zero. So you've lost that whole position. But again, maximum profit, theoretically unlimited. But again, you're taking on a lot more risk for that return. And in radiology, we don't necessarily need to do that. As one of the commenters pointed out, we're generally really well compensated. We can try and hit singles rather than going for that huge swing and striking out versus hitting the home run. If we hit singles, we'll mostly be fine, as Cindy and Chris so elegantly have outlined. Again, covered calls. This is one thing that I experimented a lot with because it sounded like extra dividend. So this is basically if you own a stock, you can sell the option to somebody to buy that stock from you if it goes up to a certain level. And it's basically extra income coming in because you really hope that expires worthless and then you just collected that money for nothing. It sounds great in theory, but what it does is it really limits your upside. And what they know is that they know how to sell these options. If these are really volatile stocks, you'll get a lot when you sell your covered call, but you'll also limit that upside. If it's a really stable stock, they don't sell it to you for very...or you can't sell it for very much, so you don't gain a lot either. A special option that you've probably all heard of is the VIX index, so you can buy and trade options on the VIX index. And this is kind of the volatility. As you can see, it's been fairly low, and then there's peaks and spikes. So again, if you want to trade in volatility, the VIX is one way to do it. So options, a way to supercharge returns using leverage. The losses are limited but unlimited for higher-level strategies. These are some things that you really have to consider. It's low volumes, large spreads between what they're buying and selling with, and they're really difficult to price for the average investor. And then you need to consider that time decay, where basically, as you own this option, it's basically going down to zero, right, because deadline is coming up. So commodities is something else you can think about owning. You can own gold, other precious metals. You can own it in different ways. You can physically buy it. I know Costco has had sales on gold, and they've sold millions and millions of gold and really supercharged their sales that way. You can buy ETFs, and then you can buy futures and future contracts. Agricultural, you can do futures exchange-traded notes. Again, I've played with those exchange-traded notes and the physical stuff. Be careful with those exchange-traded notes. Even though they are buying the commodity, they're kind of letting you invest in the commodity. It's really indirect. There's lots of fees associated with it and a lot of volatility that you might not think of. So why would you want to invest in this? Again, if you want to play around with commodities, the reason to invest in it is it's really not as well correlated with all of your other asset classes, right? And that's what Chris talked about. You want things that are uncorrelated. Again, it offers some diversification. So this is the return of different investments during the 1970s. And in recent times, you can see as the market goes down, as commercial real estate goes down, gold and silver tend to do well. And so it's uncorrelated. And so that's what you want when you're trying to diversify away from stocks and bonds. Again, long-term returns. Warren Buffett has said, basically, an ounce of gold will buy you a nice suit and gold kind of tracks with inflation. He's kind of right. So one ounce of gold was 600 back then. It's now around 2,600. I put this through a calculator. The real annual rate of return in gold, if you had invested from 1915 to now, is about 1.6%. So again, pretty close to that level of inflation. Currencies. We'll talk about a lot of different currencies. So foreign exchange. Currencies basically rise and fall. There's been a huge rise in foreign currency trading volume in the U.S. recently. So this is like trying to buy the European, the euro, or buying the yen. If you recall, there was a day of market crash and it was all caused by the yen carry trade. This was basically people doing this carry trade where they were doing interest rate arbitrage. So Japan was paying low interest rates. We were paying high interest rates. They were borrowing in Japanese and paying the interest rate there, and then buying U.S. currency to get the higher interest rate there. Again, when the yen came up, a lot of them had to unwind their bets. It caused a lot of volatility in the market. And just remember, this is a zero-sum game. Everyone's trading with somebody. And so with the fees, this can be, unless you have some kind of knowledge or some kind of pattern that you think you can do, it's someone else is losing when you're winning. Special category of currency. I think it's currency. I'm not quite sure what to call it yet, but it's cryptocurrency. So if you look at Bitcoin, Bitcoin has really gone up and up and up and up. So I think what I'm struggling with now is how to characterize crypto. Is it a currency where there's a winner and loser on every end? Is it more like a store of value, like precious metals, because that argument has been made? Or is it this unique asset class that goes up and up and up? I'll leave you to decide that, but the main coins really have had a really meteoric rise. So as a recap, always remember you are balancing, whenever you're moving into alternative investments, which are, again, completely optional, you're balancing risk versus reward. Leverage and options are mostly, I think, for day traders or people who really want to dabble in this. I think if you want to dabble, commodities and currencies are kind of neat for diversification, but in my personal portfolio, I kind of keep it to less than 10%. Again, thank you so much. Thanks, Sherwin, and thanks to you and to Chris for inviting me to speak. So now that you have accumulated all these assets, and you've reached a stage in your life where you want to think about protecting them, we're going to touch on some concepts of asset protection for radiologists. So I'm going to touch on two main topics. The first are going to be general considerations for how to best protect your assets from lawsuits, malpractice suits, and judgments. And then I'll talk briefly about some more specific asset allocation strategies. So let's begin by talking about what are assets. So these are the list of assets that I'm referring to, obviously savings, checkings, cash, and insurance. Some insurance policies, as you probably know, can be considered as assets, such as whole life or universal or variable premium life insurance, which have some intrinsic cash value and can be used as collateral. And then I'm going to talk briefly about loan. So those can be considered as financial assets. Also, in some states, there is provision for protecting assets for whole life insurance policies. Obviously, investments, as we heard from Dr. Chan and Dr. Lee, stocks, bonds, and mutual funds. Annuities are an interesting entity. These are contracts between an individual and an insurance company where the purchaser makes payments either in installments or in a lump sum. And then the insurance company, in exchange for that, provides a stream of income for the annuity holder, usually for retirement purposes. Obviously, businesses that you own or invest in or equipment involved with those businesses would be considered as assets. And obviously, your home or other property that you may own or other real estate investments would be additional assets to consider. So just beginning with considerations for protecting assets, in particular from lawsuits or judgments, which always makes us nervous, here's a list of things to consider, a number of basic asset protection strategies that you can employ that are important. So the first is that of marriage and civil union. Marriage, civil unions have really been sort of outmoded, phased out because of the legalization of same-sex marriage. And they don't provide the same federal benefits as do marriage. Marriage, as I think Dr. Lee touched on, presents the greatest risk to one's assets. Now, I am not suggesting that being married is not a worthwhile effort. I have my wife here with me who I love dearly, and I highly recommend it. It obviously has a number of various benefits, not simply just financial but also health and well-being and longevity benefits. But from your pure asset protection strategy, marriage and potential divorce is your greatest risk as relates to your assets. So just again, I highly recommend it. Dear. So first question to pose here. So which of the following U.S. healthcare professionals have the highest divorce rate? Is it A, physicians, B, dentists, C, pharmacists, or D, nurses? So I'll move to the poll here. Oh, we've got physicians, dentists, pharmacists. Okay. So it looks like most of you have chosen physicians. I'm pleased to say that that is not the correct answer. It turns out to be nurses. So this is actually a paper from a review actually of divorce rates amongst healthcare professionals. You can see the overall rate of divorce amongst physicians is about one in four, so about 25%. Interestingly, women physicians have a higher divorce rate than do men, as you can see here, and the highest rate of divorce in healthcare profession is amongst nurses. One of three nurses will end up getting divorced during his or her lifetime. Interestingly, prenuptial agreements, which is something certainly to consider if you're thinking of getting married. Interestingly, only 15% of American couples have prenuptial agreements. You can see it's much higher than it was just 15 years ago. But in a recent survey done by the Harris Poll, you can see over 40% of individuals support the concept of prenuptial agreements. So that is certainly one way to address the risk of marriage as far as asset protection is concerned. There are obviously some business-related asset protection considerations. A limited liability company, or LLC, is a separate entity where a business owner can protect themselves from personal liability for any of the company's debt. These are simpler than corporations. Corporations have intrinsically requirement for bylaws, corporate minutes. You have to have directors and officers and shareholders involved. Members of LLCs cannot be named in a lawsuit, and the LLC does not pay taxes. It's a pass-through entity in which the individual members pay as part of their personal tax return through taxes incurred by the limited liability company. These are excellent entities to consider for rental properties. As I mentioned, corporations also create the separation between the owners of the corporation and their businesses, but they're much more complex entities. They don't provide the same protection as do LLCs. Limited partnerships are terrific vehicles for asset protection with both estate and personal tax benefits. Limited partners have no personal liability and only stand to lose whatever they've contributed to the partnership. They have no management role in the partnership itself. Like with LLCs and unlike corporations, they're pass-through entities, and so the individuals are responsible for the taxes incurred in the limited partnership. Family limited partnerships are excellent vehicles for protecting family wealth from lawsuits. For example, a husband and wife can be general partners in an FLP, and they can own each individually 1% or 2% of the limited partnership, but the remaining 98% or 99% of the assets can be owned by the partnership itself, and so the partners are not liable for any judgments made against the limited partnership. Insurance, obviously, is an extremely important consideration, and no discussion of asset protection would be complete without considering insurance. Liability insurance is the first line of defense, as any blog post or book or lawyer will tell you, in the defense against lawsuits. And obviously, there's a number of different types of insurance. I won't go into detail about malpractice insurance or business related insurance, but there's a whole variety of them, and here you can see just a brief list of those types of insurance. You can see, again, disability insurance. You're much more likely to become disabled than you are to die, so disability insurance is way more important to have as you go through your career than would be life insurance. You can see only 15% of Americans actually hold disability insurance, and there's a variety of other insurances. I know we have umbrella insurance to cover other things beyond auto insurance and home insurance, and so that's always a good thing to consider as well. And then there's obviously insurance to protect your business. So I just want to talk a little bit about malpractice risk for radiologists because this is something I think we all find to be a little bit anxiety provoking. This is actually a paper from the New England Journal. This is probably the best summary paper on malpractice for physicians that I've been able to find. You can see this is a large survey, over almost 41,000 physicians, 234,000 physician years, with an overall mean time of a little less than six years of practice. You can see the demographics here. This is a study over 15 years of time in all the states. And what they did is looked at the percentage of physicians that faced a malpractice claim, the percentage of those claims that led to a payment, the size of those payments, and then they estimated the cumulative risk of being sued by each of the various specialties. And so they divided them into high and low risk fields. So this is going to be really hard to read, so I'm just going to magnify this because I think we're all pretty much interested in where radiology is in the mix of malpractice claims. So these are the number of claims. You can see here that for all physicians, all specialties, about 7.4% of all specialties ended up being sued in that time frame during that study. About 22% or 1.6% ended up in some type of a claim or settlement. Interestingly, for diagnostic radiology, you can see we're just below the mean for all specialties. 7.2% ended up being sued. And again, about the same rate of claims of those that were sued, 22% or 1.6% overall. So my next question for you is regarding the average amount, not the number of claims, but the amount of an average claim, where do radiologists fall? Is it into the top quartile, A, B, third quartile, C, second quartile, or D, lowest quartile? So where do we fall as far as how much each of the claims that ended up getting settled or paid out, where do we fall? So it looks like it's pretty evenly distributed. I think most people feel it's somewhere in the middle two quartiles. And indeed, we're actually a little bit, again, below the mean. So this is just looking at the size, not the number, but the size of the claims paid by specialty. You can see here average payout is $275,000 with a median of $112,000. You can see we're just slightly below the mean, so in that third quartile, so not nearly as bad as you'd think. When you look at, again, us compared to the other specialties, you can see that it's somewhat lower than all physicians. The ones that are the highest, as you would imagine, are neurosurgery, internal medicine, interestingly, pulmonary medicine, interestingly, probably because of lung cancer malpractice, and general surgery. So I just want to briefly touch in the last couple of minutes on asset protection plans. I'm not going to go into great detail about this, but just to point out that many of the federal and state-specific asset protection issues need to be considered. And if you look at the White Coat Investor, which I think has been referenced as one of the useful places to look online, there is a book that James Dolly, who's the author and has created the White Coat Investor, he's written a book specifically on asset protection. And you need to know what the issues are in your specific state. Just briefly, the Arizor Employment Retirement Income Security Act of 1974, it's a federal law that protects all non-church and government employees. It sets certain standards for health insurance, for retirement plans, like 401Ks, 403Bs. Tenants by their entirety titling is a consideration where each state, in certain states you're allowed, as a married couple, to title your property as termed tenants by their entirety. And this basically precludes the property from being available to claims and payouts. This is an option in Vermont, where I live. It's not an option here in Illinois. And then there are certain asset protection laws, again, which can be federal or state-specific, including protection for 529 accounts, 457Bs, and cash value insurance policies. So I'm going to move just quickly to the end with trusts. There are different types of trusts to consider, but I'm going to focus mostly on asset protection trusts in the last minute or two that we have. There's a variety of these. The one to focus on is a so-called asset protection trust. These can be either domestic or foreign. And they're also known as irrevocable self-settle trusts. And they are state-specific. So certain states allow for these. Others do not. Vermont and Illinois do not. If you work or live in Connecticut or New Hampshire, this is an option for you. And basically this, again, allows the funder or settler of the grant to be the beneficiary but to have a trustee or someone else manage it for the benefit of the beneficiary. And you can place long-term investments in your homestead into those trusts. And it does protect against judgments, liens, and creditors. So here are some references, some of which I think you've already seen from some of the other speakers, if you'd like to learn a little bit more about some of the asset protection strategies that you can employ in protecting some of the wealth that you've worked hard to develop over the years of your career. Thank you very much.

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